在食道癌的新辅助治疗后,器官储存方法
Matteo Pittacolo1,2, Oleksandr Khoma1,3, Sjoerd M Lagarde1
1Department of Surgery, Erasmus MC Cancer Institute, Erasmus University Medical Centre, Rotterdam, The Netherlands.
Digestive surgery
|July 29, 2025
概括
积极监测是食道癌患者的手术可行的替代方案,这些患者对新辅助治疗有完整的反应. 这种方法提供了可比的生存率和改善的生活质量,减少了手术发病率.
科学领域:
- 在瘤学瘤学.
- 手术瘤学手术瘤学
- 胃肠病学 胃肠病学
背景情况:
- 食道癌的标准治疗包括新辅助化学放射疗法 (nCRT) 或术后化学疗法,然后进行手术.
- 在多达三分之一的患者中,对nCRT的病理完整反应发生.
- 与手术相关的高发病率促使人们考虑对完全响应者进行积极监测.
研究的目的:
- 评估作为食道癌症患者在nCRT后临床完整反应的手术替代品的积极监测.
- 评估正在接受积极监测的患者的瘤结果和生活质量,与计划性手术相比.
- 验证多式联络诊断策略,以准确检测残留疾病.
主要方法:
- 多种模式的诊断策略:食管胃管腺镜与活检,内超声波与精细针吸收,和PET-CT.
- 随机试验 (例如,SANO) 将主动监测与计划手术进行比较.
- 对延迟手术的瘤结果,生活质量和手术结果的分析.
主要成果:
- 随机研究的早期结果支持积极监测和手术之间可比的瘤结果.
- 积极监测的患者报告生活质量有所改善.
- 在复发后推迟手术的结果与即时手术的结果相似,尽管最初的担忧.
结论:
- 积极监测是对完全响应者进行手术的有希望的替代方案,改善生活质量并可能降低发病率.
- 准确的响应评估和结构化的后续对成功的积极监测至关重要.
- 未来的研究,包括免疫疗法和非侵入性诊断,可能会进一步优化这种方法.
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